Continuing epilepsy, MS and Parkinson's care in Spain

Terms used

• Médico de familia — The médico de familia is your public-system family doctor, who treats you first and refers you to hospital specialists.
• Urgencias — Urgencias is the hospital emergency department, the only route to a specialist without a referral.
• Certificado de discapacidad — The certificado de discapacidad is an official disability rating, with 33% or more opening access to tax and employment benefits.
• DGT — The DGT is Spain's traffic authority, which issues and renews driving licences.
• Centro de reconocimiento de conductores — A centro de reconocimiento de conductores is an approved centre that does driver medical checks and reports to the DGT.

Key rules

• Referral: Your family doctor refers you to hospital neurology; only emergencies skip this step.
• Medication: Many MS drugs are collected from the hospital pharmacy, so agree with your neurologist who prescribes what.
• Driving with epilepsy: You need a favourable medical check before driving, and your licence is renewed more often than usual.
• Dependency help: The dependency assessment requires legal residence and normally 5 years in Spain.

Start with your family doctor

In the public system, your médico de familia is the door to a neurologist. Book an appointment, explain your diagnosis and ask for a referral to hospital neurology. The hospital or regional health service then sends your appointment by letter, SMS, app or phone, or hands it to you at your health centre. Waits run from weeks to several months, depending on your region.

The only way in without a referral is the emergency department (urgencias). Use it for urgent problems, not for routine follow-up.

If you use private care or a mutua such as MUFACE, your route is different. Ask your insurer how to reach a neurologist.

What neurology does for you

Neurology diagnoses and follows epilepsy, MS and Parkinson's. Once you are under a specialist, they set your review appointments (citas sucesivas), so ask for the next one before you leave. Larger hospitals have specialist units for epilepsy, MS and movement disorders. Your neurologist refers you to them, so ask whether one is available in your area.

Who prescribes your medication

Your neurologist usually prescribes. Your family doctor can then issue repeats through electronic prescription. Many MS disease-modifying drugs, and some others, are collected from the hospital pharmacy instead of a regular one. Agree early with your neurologist who prescribes each drug and where you collect it.

Rehabilitation and support

Public rehabilitation covers physiotherapy, occupational therapy and speech therapy through hospital rehabilitation services. Patient associations, such as MS and Parkinson's federations, offer extra support and are often subsidised.

Two assessments can open further help. Both are handled by your region's social services, and procedures and waits differ by region.

• Disability certificate (certificado de discapacidad): needs a rating of 33% or more. It gives access to tax and employment benefits.
• Dependency assessment: it sets a degree of dependency and the services or benefits that go with it. You must be a legal resident. It also requires a minimum period of residence in Spain, normally 5 years.

The documents box below lists what to prepare.

Driving with epilepsy

You need a medical check at a centro de reconocimiento de conductores. It sends a report to the DGT, which decides on your licence.

• Car or motorbike (group 1): you are generally fit to drive after about one year without seizures, with a favourable report from your neurologist.
• Professional licences (group 2): the seizure-free period is much longer, around 10 years, and usually without medication.
• Validity: licences are issued for a shorter time, often 1 to 5 years, so you repeat the check when it expires.
• Foreign licences: an EU/EEA licence is valid in Spain, but you must still meet the Spanish medical criteria. A non-EU licence may need exchanging, or is valid only for a limited time after you become resident, depending on agreements. Check yours with the DGT.

Your centre and the DGT decide your exact seizure-free period and validity, so ask them about your case before you drive.

Documents you need

• Disability certificate (certificado de discapacidad) showing 33% or more, issued after assessment by your region's social services assessment centre. It gives access to tax and employment benefits.

• Dependency assessment resolution under the dependency law, issued by your regional social services. It sets your degree of dependency and the services or benefits you can receive.

• Proof of legal residence in Spain. The dependency assessment also requires a minimum period of residence, normally 5 years.

Checklist

• Book an appointment with your family doctor (médico de familia) and ask for a referral to hospital neurology.

• Go to the emergency department (urgencias) if you have an urgent problem, as it is the only route without a referral.

• Agree who prescribes your medication, and ask whether any of your drugs are collected from the hospital pharmacy.

• Ask your neurologist for review appointments so follow-up continues.

• If you have epilepsy and drive, book the medical check at a driver assessment centre and bring a favourable neurological report.

• Check your licence type and validity with the DGT, including whether a foreign licence needs exchanging.

Frequently asked questions

Can I drive in Spain if I have epilepsy?

Yes, you can usually drive a car or motorbike in Spain once you have been seizure-free for about one year and have a favourable neurological report. You must pass a medical check at a driver assessment centre (centro de reconocimiento de conductores), which sends a report to the DGT.

How long is a driving licence valid with epilepsy?

Licences for people with epilepsy are often issued for 1 to 5 years, so you will have periodic renewal checks. The exact period depends on your case and the centre's assessment.

Who prescribes and dispenses my MS or Parkinson's medication?

Your neurologist usually prescribes it, and your family doctor issues repeats through electronic prescription.